For Stage I

When cancer limited, has spilled outside of the duct or lobule, but remains 2 cm or less in size. No cancer is in the nodes.

Most patients with a single, small lesion are candidates for lumpectomy plus radiation therapy. Endocrine therapy and/or chemotherapy may be considered.

For Stage II

Cancer measures from 2 to 5 cm (up to 2 inches), and may have early spread to the nodes. Stage IIB also includes cancers larger than 5cm, but with no node involvement.

Lumpectomy and radiation therapy or mastectomy. Chemotherapy if there is node spread, and for tumors greater than 1 cm. Use endocrine therapy (e.g., tamoxifen) if either hormone receptor (ER, PR) is positive.

Patients with larger tumors are often treated with chemo first to shrink the tumor and thereby enable lumpectomy. May consider systemic therapy (e.g., chemotherapy) followed by lumpectomy plus radiation therapy.

For Stage III

Locally advanced cancer. For example, there is significant involvement of the nodes, or the tumor has invaded the chest wall and/or skin.